NPIMap

Organization Active NPI

Boston Dental LLC

  • Dentist
  • Boston, NY
National Provider Identifier
1265737571
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32221 Issued in NY
Legal business name
BOSTON DENTAL LLC
Practice address
8397 Boston State Rd
Boston, NY 14025-9651
Phone
(716) 941-5433
NPI assigned
Jan 18, 2011
Last updated
Jan 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Charles Alan Matlach, D.D.S.NPI 1306859483
Title
Owner
Phone
(716) 941-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 32221 NY Primary

Addresses

Primary practice location

8397 Boston State Rd
Boston, NY 14025-9651

Mailing address

8397 Boston State Rd
Boston, NY 14025-9651
Phone (716) 941-5433

National Provider Directory

National Provider Directory

Locations

8397 Boston State Rd
Boston, NY 14025
Phone (716) 941-5433

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1265737571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8397 BOSTON STATE RD",
            "city": "BOSTON",
            "state": "NY",
            "postal_code": "140259651",
            "telephone_number": "716-941-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8397 BOSTON STATE RD",
            "city": "BOSTON",
            "state": "NY",
            "postal_code": "140259651",
            "telephone_number": "716-941-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "MATLACH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-941-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "32221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.